I Can Hear You Now: Clinic Provides Free Hearing AIDS for Low-Income Adults

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How a new Ann Arbor program helps those with hearing loss — and provides a blueprint other academic medical centers may follow

New Ann Arbor program helps those with hearing loss — and provides a blueprint other academic medical centers may follow.

Newswise, June 29, 2017 — Low-income people dealing with hearing loss just got a little hope.

Doctors from Michigan Medicine’s Department of Otolaryngology — Head and Neck Surgery partnered with the Hope Clinic to create Hope for Hearing, a program that provides free hearing aids to uninsured adults.

The partnership between the free independent clinic and University of Michigan started in 2010 to provide Hope Clinic patients with access to specialty care.

“We saw there was a need for hearing aids,” says Aileen P. Wertz, M.D., a fifth-year resident in otolaryngology who also sees patients at the Hope Clinic. “Over half of the patients referred to us with ear complaints had hearing loss and could simply benefit from a hearing aid.”

After recognizing the need, Wertz and her colleagues looked to design a self-sufficient subspecialty program within the clinic that could act as a model for similar projects.

They began by soliciting hearing aid donations and a hearing aid verification system and securing a $5,000 grant for a computer enabled with audiological software and other equipment.

Primary care providers then referred adults with hearing complaints to the program.

Patients went through an initial assessment that included a formal audiogram and screening evaluation. If the audiometric test suggested a significant hearing loss and the otolaryngologist determined that a patient was medically cleared for hearing aids, the patient was referred to audiologists for hearing aid counseling and fitting.

In a study published in JAMA Otolaryngology—Head & Neck Surgery, Wertz and her colleagues examined the feasibility and outcomes of the program.

“During the study period — September 2013 through March 2016 — we garnered 84 hearing aids, and most of them were donated,” says Wertz. “Thirty-four patients were determined to be eligible for the free program and were offered hearing aid services. Of them, 20 patients (59 percent) have been fitted or are being fitted with free hearing aids.”

The cost of hearing aids

Most people who need hearing aids are surprised that neither Medicare nor most commercial insurance plans cover the cost. As a result, there is no price negotiation or consumer benefit.

Wertz says the average Hope for Hearing patient would pay about $2,260 to obtain equivalent equipment themselves or pay $1,210 for the most basic hearing aid available at U-M.

The only costs for Hope for Hearing patients are batteries for the hearing aid and transportation to and from their clinic visits.

What’s ahead

Deemed a success with room to grow, Wertz says the Hope for Hearing program is looking for ongoing funding to cover the costs of ear mold and hearing aid supplements.

Wertz attributes some of the success to date to the strong relationship between the Hope Clinic and U-M.

“This hearing aid program began with an established, successful academic center-community program partnership,” she says. “That was an important factor because enthusiastic audiologists and otolaryngologists were already invested and volunteering regularly at clinics.”

Wertz suggests that other institutions considering similar programs think about the target population’s cultural needs.

“Many patients in this program have required an interpreter to get through the audiologic evaluation and hearing aid fitting,” says Wertz. “Our program has been fortunate that a family member or friend with bilingual abilities has been able to serve as an interpreter for appointments.”

Electronic Records Help Link Genes To Age-Related Hearing Loss

 UCSF-Kaiser collaboration studied more than 6,000 cases of hearing impairment

Newswise, October 26, 2016 — A study of patient electronic medical records and genome sequences from adults with age-related hearing impairment by researchers at UC San Francisco and Kaiser Permanente Northern California, identified two genetic variations linked to the hearing disorder.

The research—led by Thomas Hoffmann, PhD, a professor of epidemiology and biostatistics and member of the Institute for Human Genetics at UCSF—was published October 20, 2016 in PLOS Genetics.

“This is one of the first studies that has found and replicated genes linked with age-related hearing impairment,” Hoffmann says.

“And it provides some of the best evidence to date that age-related hearing loss may share a common biological basis with other forms of hearing impairment.”

Age-related hearing impairment (ARHI) is a common condition, affecting one quarter of individuals aged 65, and half of individuals aged 80 and older.

While hearing aids and other technologies offer treatments, scientists hope that a better understanding of the underlying genetics of the disorder may one day yield a cure.

To find genetic variations linked to ARHI, the scientists conducted a genome-wide association study using 6,527 age-related hearing impairment cases and 45,882 controls among white participants in the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort, a collaboration between UCSF and the Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH).

“Our collaboration with Kaiser is incredibly powerful,” Hoffmann said. “They have a very long history of electronic health records on all of their patients in the system, so as a researcher you have this rich set of information that you can look at to understand the factors that drive health and disease.”

The researchers discovered two genome variants that contribute to the disorder: a novel variation near the ISG20 gene, and a second variant within TRIOBP, a gene previously associated with another type of hearing loss.

To verify their findings, the scientists replicated the experiment in Latino, East Asian, and African American cohorts within GERA and in an independent cohort of individuals from the UK Biobank.

They also looked at genes known to play a role in hearing loss and identified two additional genetic variations linked to ARHI.

This study provides novel insights into the genetic factors involved in ARHI. In particular, the discovery of the two additional variations in known hearing loss genes suggests that these may be regions of the genome to focus on in future studies of ARHI.

The findings also highlight the utility of large cohorts with matched genomic data and electronic health records for revealing the underlying genetic basis of ARHI and other disorders.

“This has been a long process,” Hoffmann says of the project to collect genomic data and link it with GERA health records.

“It’s really nice to see at the end that all the collaborative work that we’ve done is producing interesting results that help advance the field.”

Additional authors on the paper include Bronya J. Keats, PhD, of Louisiana State University Health Sciences Center; Noriko Yoshikawa, MD, of Kaiser Permanente Medical Center, Oakland; Catherine Schaefer, PhD, of Kaiser Permanente Northern California Division of Research, Oakland; Neil Risch, PhD, who is Lamond Family Foundation Distinguished Professor in Human Genetics, professor of epidemiology and biostatistics, and director of the Institute for Human Genetics at UCSF and an adjunct investigator at the Kaiser Permanente Northern California Division of Research; and Lawrence R. Lustig, MD, of Columbia University Medical Center.

Funders of the research include the National Institute of Deafness and Other Communication Disorders (grant K01 DC013300), the National Institute on Aging, National Institute of Mental Health, the National Institutes of Health Common Fund (RC2 AG036607), the Robert Wood Johnson Foundation, the Wayne and Gladys Valley Foundation, the Ellison Medical Foundation, and Kaiser Permanente National and Regional Community Benefit Programs. The authors have declared no competing financial interests.

About UCSF: UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospitals in San Francisco and Oakland – and other partner and affiliated hospitals and healthcare providers throughout the Bay Area. Please visit www.ucsf.edu/news and follow @ucsf.

About the Kaiser Permanente Division of Research: The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 550-plus staff is working on more than 350 epidemiological and health services research projects. For more information, visit http://www.dor.kaiser.org or follow us @KPDOR. 

UTEP Professor Shows That Hearing Aids Improve Memory, Speech

Newswise, January 29, 2016 — A recent study by Jamie Desjardins, Ph.D., an assistant professor in the speech-language pathology program at The University of Texas at El Paso, found that hearing aids improve brain function in persons with hearing loss.

Hearing loss, if left untreated, can lead to serious emotional and social consequences, reduced job performance and diminished quality of life. Untreated hearing loss also can interfere with cognitive abilities because so much effort is put toward understanding speech.

“If you have some hearing impairment and you’re not using hearing aids, maybe you can figure out what the person has said, but that comes with a cost,” Desjardins explained. “You may actually be using the majority of your cognitive resources – your brain power – in order to figure out that message.”

As people age, basic cognitive skills – working memory, the ability to pay attention to a speaker in a noisy environment, or the ability to process information quickly – begin to decline.

Desjardins studied a group of individuals in their 50s and 60s with bilateral sensorineural hearing loss who had previously never used hearing aids.

They took cognitive tests to measure their working memory, selective attention and processing speed abilities prior to and after using the hearing aids.

After two weeks of hearing aid use, tests revealed an increase in percent scores for recalling words in working memory and selective attention tests, and the processing speed at which participants selected the correct response was faster.

By the end of the study, participants had exhibited significant improvement in their cognitive function.

“Most people will experience hearing loss in their lifetime,” said Desjardins, who joined UTEP in 2013. “Think about somebody who is still working and they’re not wearing hearing aids and they are spending so much of their brainpower just trying to focus on listening.

“They may not be able to perform their job as well. Or if they can, they’re exhausted because they are working so much harder. They are more tired at the end of the day and it’s a lot more taxing. It affects their quality of life.”

Hearing loss affects more than 9 million Americans over the age of 65 and 10 million Americans ages 45 to 64, but only about 20 percent of people who actually need hearing aids wear them, Desjardins said.

Desjardins’ new study focuses on the use of hearing aids by Hispanics. Research shows that only five percent of Mexican-Americans wear hearing aids. She has developed a survey to investigate their attitudes toward hearing loss. The survey will be conducted at health fairs in the community, including the Mexican Consulate in El Paso, Texas.

Desjardins also will begin work on another study that will look at older bilingual people and their ability to understand speech.